Gary Robert Diel, D.C.
Individual provider Active NPI Chiropractor · Fife, WA
NPI 1033154307 · NPPES record last updated Nov 14, 2011
Key facts
- NPI
- 1033154307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH00002015 (WA)
- Practice address
- 1406 54TH Ave E
Suite D
Fife, WA 98424-1284 - Phone
- (253) 304-5660
- Fax
- (206) 497-8215
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH00002015 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & D Coulson Inc. | Past | Accepting new patients | |
| South Tacoma Chiropractic and Rehabilitation, PLLC | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00002015 | WA | Yes |
Addresses
Primary practice location
1406 54TH Ave E
Suite D
Fife, WA 98424-1284
Mailing address
PO Box 1151
Puyallup, WA 98371-0227
Phone (253) 304-5660
Other providers in Fife, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.